Intercostal Nerve Block, Post-operative Pain Management, Serratus Posterior Superior Intercostal Plane Block, VATS
Conditions
Keywords
Serratus posterior superior intercostal plane block, intercostal nerve block, VATS
Brief summary
This study aims to evaluate the effectiveness of Serratus Posterior Superior Intercostal Plane (SPSIP) block compared to Intercostal Nerve (ICN) block in terms of postoperative pain control, reduction of opioid analgesic consumption, minimization of postoperative respiratory complications, and increase patient satisfaction (using a 5-point Likert scale) in patients undergoing video-assisted thoracoscopic surgery (VATS).
Detailed description
In this prospective observational study, patients included in the study will receive Serratus Posterior Superior Intercostal Plane (SPSIP) block and Intercostal Nerve (ICN) block for postoperative analgesia at the end of surgery. The SPSIP block will be performed by the anesthesiologist under ultrasound guidance immediately after skin closure and before extubation, while the ICN block will be performed by the surgeon under direct vision immediately before skin closure. At the end of surgery, patients will receive 1000 mg paracetamol and 50 mg dexketoprofen during skin closure. Upon arrival at the recovery room, each patient will be connected to a patient-controlled analgesia (PCA) pump containing tramadol. At postoperative reassessment, patients with a Numerical Pain Rating Scale (NPRS) score greater than 4 despite PCA use will receive a rescue analgesic dose of 50 mg dexketoprofen. Postoperative pain intensity will be assessed using the NPRS (Numerical Pain Rating Scale) at 1, 4, 6, 12, 18, and 24 hours postoperatively, both at rest and during coughing. Total opioid consumption, rescue analgesic use, and postoperative complications will be recorded. Patients will be informed about their level of surgical satisfaction 24 hours after surgery, and this information will be recorded.
Interventions
None listed
Sponsors
Kocaeli City Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Aged 18-80 years, * American Society of Anesthesiologists (ASA) physical status I-III * Patients who have provided informed consent to participate in the study
Exclusion criteria
* Patients who refuse to participate in the study by not signing the informed consent * Patients classified as ASA \> 3, according to the system established by the American Society of Anesthesiologists * Patients unable to understand the use of the NPR Scale or the PCA device that will be used for postoperative analgesia * Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia * Patients with allergies to analgesic and/or anesthetic drugs * Infection at the block injection site * Patients whose surgical procedure is intraoperatively converted to an open pulmonary resection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain intensity | 24 hours after the end of surgery | In both study groups, postoperative pain intensity at rest and with coughing was measured using the Numerical Pain Rating Scale (NPRS), a numerical scale ranging from 0 to 10 (0 meaning no pain, 10 meaning the most severe pain imaginable). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total opioid drug consumption | 24 hours after the end of surgery | The total amount of opioid doses administered via a Patient Controlled Analgesia (PCA) device in the first 24 hours after surgery |
| Consumption of rescue analgesics | 24 hours after the end of surgery | The total dose of dexketoprofen required by the patient during each specified time interval in the first 24 hours after surgery. |
| Postoperative Complications | 24 hours after the end of surgery | Postoperative complications such as nausea, vomiting or other adverse events will be recorded |
| Patient satisfaction score | At the 24th hour post-operation | evaluated using a 5-point Likert scale (1=very dissatisfied, 5=very satisfied) |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORAyşe Z Turan Cıvraz, Assoc. Prof.
Kocaeli City Hospital
Outcome results
None listed